27 February 2013

It’s like whacking gophers in that classic
arcade game; no matter how many times you debunk the argument that too much
reason and science gave us Nazism and Stalinism, it keeps popping back up.
Which it did in a Facebook discussion I participated in recently.
Apparently, all one has to do is promote reason, critical thinking and the
scientific method as the only paths to (provisional) knowledge and eventually someone will
feel obligated to play the ‘rational totalitarianism’ card as a corrective.
Someone like the quitting Pope Benedict XVI, or the philosopher John Gray, the
latter being schooled by his confrere A C Grayling on why making a tenuous
connection between 20th century totalitarianism and Enlightenment
values – which include a healthy respect for science – is so full of fail.

In his typically elegant prose, Grayling
demolishes the idea that Nazism and Stalinism were the logical culmination of
overzealous rationality and ‘scientism’:

As to the weary old
canard about the 20th-century totalitarianisms: it astonishes me how those who
should know better can fail to see them as quintessentially
counter-Enlightenment projects, and ones which the rest of the
Enlightenment-derived world would not put up with and therefore defeated:
Nazism in 17 years and Soviet communism in 70. They were counter-Enlightenment
projects because they rejected the idea of pluralism and its concomitant
liberties of thought and the person, and in the time-honoured unEnlightened way
forcibly demanded submission to a monolithic ideal. They even used the forms
and techniques of religion, from the notion of thought-crime to the embalming
of saints in mausoleums (Lenin and Mao, like any number of saints and their
relics, invite pilgrimage to their glass cases). Totalitarianism is not about progress
but stasis; it is not about realising a golden age but coercively sustaining
the myth of one. This indeed is the lineament of religion: it is the opposite
of secular progressivism.

Other critics of scientific rationality
like Max Horkheimer and Theodor Ardono are also guilty of false equivalence
when they paint science as just another kind of totalitarian ideology, with the
same capacity to oppress. In the introduction to The Britannica Guide to the Ideas That Made the Modern World, Grayling again rebuts these
critics by pointing out the fallacies of their arguments. He writes:

In the crisis of the 1930s
and 40s the oppressive power that Horkheimer and Adorno had in mind was Nazism,
which they saw as the Enlightenment’s self-fulfillingly paradoxical outcome: in
their terminology, “instrumental rationality” had been transformed into
“bureaucratic politics”. In effect, Horkheimer and Adorno were claiming that
the Enlightenment empowered capitalism and with it a deeply oppressive form of
managerialism that served its interests to the exclusion of all others.

This analysis does not survive scrutiny.
Nazism drew its principal strength from a peasantry and petit-bourgeoisie that mostly
felt threatened by capitalism, so it is not the latter which was the source of
oppression, but in fact the former, viewed as descendents of the various
constituencies that had most to lose from Enlightenment and which therefore
reacted against it. The votaries of Nazism, had they lived in the eighteenth
century, would have defended the traditions of absolutism, whether in
Versailles or in heaven, against the “instrumental rationality” which expressed
itself in the eighteenth century as secularizing and democratizing
impulses.

And the key passage, with my emphasis in
bold:

As this implies, the same
answer can be addressed to the other example cited by critics as an inheritor
of Enlightenment principles, namely Stalinism. The general point to be made is
that totalitarianism, of which Nazism and Stalinism are paradigms, is a
monolithic ideology that demands the unwavering loyalty and obedience of all.
Whether in the form of a religion or a political movement, it is
precisely opposed by the Enlightenment values of individual
liberty, freedom of thought, consent of the people, rational argument, the
constraints of evidence, and the absence of controlling
hegemonies.

Not exactly rational guys.

So, for the umpteenth time, a commitment to
reason and science does not lead to genocide, or gas chambers, or gulags, or
personality cults, or delusions of ethnic superiority. Quite the opposite.

I’ll let Grayling have the last word, since
he says it so well.

By resisting the
counter-Enlightenment pessimism of Horkheimer and Adorno in this way one sees,
by the intended contrast, how much of the Enlightenment remains operative in
the contemporary world as the same force it was historically intended to be: a
force for progress, for liberty, for rationality.

18 February 2013

The New
Yorker has an article by Michael Specter on Dr Mehmet Oz, a heart
surgeon who is also the host of ‘The Dr. Oz Show’, a hugely popular US
television program watched by millions of Americans. Dr Oz is notorious for his
refusal to disavow ‘alternative’ medicine as unscientific and unproven; he
promotes quackery like ‘miracle’ foods and cures, anti-GMO and anti-vaccine propaganda,
Reiki, acupuncture, homeopathy and psychic powers alongside real, effective medical advice.
To quote one of his critics, the cardiologist and professor of genomics Eric
Topol, Dr Oz’s lack of discrimination between evidence-based medicine and
alt-med can mislead people, since “how are consumers to know what is real and
what is magic? Because Mehmet offers both as if they were one.”

Scientists often argue
that, if alternative medicine proves effective through experimental research,
it should no longer be considered alternative; at that point, it becomes
medicine. By freely mixing alternatives with proven therapies, Oz makes it nearly
impossible for the viewer of his show to assess the impact of either; the
process just diminishes the value of science.

Neurologist Dr Steven Novella (who has been
a guest on ‘The Dr. Oz Show’) is another critic of Dr Oz, writing in a blog post
that “Promoters of alternative
medicine [like Dr Oz] only pay inconsistent lip-service to science, but the
core of their philosophy is that science is optional,” and that this is “a very dismissive attitude – the casual
dismissal of scientific evidence simply because it contradicts a pet belief.”

The problem of shoddy methodology in
medical science, whether in research or in the media, is also touched on by the
physician and writer Dr Ben Goldacre in his book Bad Science. As a media personality, the issue of how entertainment values
and populism subvert medicine is pertinent to Dr Oz’s case. He
seems to think that truth is a democracy, that facts are determined not by the careful
examination of reality but by popular vote. These personal beliefs about truth
and facts are a core factor in Dr Oz’s promotion of quackery, as this passage
from Specter’s article reveals:

”Either data works or it
doesn’t,“ I [Specter] said. “Science is supposed to answer, or at least
address, those questions. Surely you don’t think that all information is
created equal?”

Oz sighed. “Medicine is a very religious
experience,” he said. “I have my religion and you have yours. It becomes
difficult for us to agree on what we think works, since so much of it is in the
eye of the beholder. Data is rarely clean.” All facts come with a point of
view. But his spin on it – that one can simply choose those which make sense,
rather than data that happen to be true – was chilling. “You find the arguments
that support your data,” he said, “and it’s my fact versus your fact.”

Dr Mehmet Oz is an epistemological
relativist; to him, there is no such thing as objective truth, and
unsubstantiated medical claims are just as valid as those backed by a mountain
of evidence. With such a rotten ideological foundation, should it surprise us
that his house of medical knowledge is so unsound? The tragedy is that Dr Oz
has an impressionable audience of millions, many of whom may be harmed, not
empowered, by the relativism of ‘America’s doctor’.

04 February 2013

Medicine has a dirty little secret: not all clinical trial
results for drugs are reported, with positive results being “around twice as
likely to get published as negative findings”, according to Dr Ben Goldacre, a medical
science writer. Dr Goldacre calls this bias “a cancer at the core of
evidence-based medicine” and has written a book, Bad Pharma,
that addresses this widespread problem.

Evidence-based medicine (EBM) should take into account
all clinical trial results, and not just cherry-pick the
outcomes that match the drug manufacturer’s expectations, or quietly sweep the
failed tests under the carpet. It isn’t evidence-based medicine if it doesn’t
include all the evidence, even the negative ones. Those of us who criticise ‘alternative’
medicine for its lack of rigour and flawed methodology should be just as
critical of similar trespasses in EBM. In fact, by claiming to be scientifically committed, EBM should be held to a higher standard of conduct.

There’s a petition calling for private and public medical researchers
to publish all clinical trial results, both successes and failures, with test
methods clearly described. Please sign it to show your support for
evidence-based medicine that truly lives up to its name.

Here’s a TED talk by Dr Goldacre on the pernicious bias
shown by drug researchers for positive clinical trial results, and why it has to stop. You
will not find a more passionate, or animated, defender of proper
evidence-based medicine.